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Objective:To investigate the Chinese anesthesiologist′s proficiency, training experience and needs of flexible bronchoscope-guided awake flexible bronchoscopy intubation (AFBI) using a questionnaire method.Methods:The cluster sampling was used, and self-designed questionnaires that addressed 54 questions in 5 categories were distributed through WeChat and online platforms. The survey took one month, and the answers were automatically recorded by the WeChat server.Results:A total of 1 250 anesthesiologists participated in the survey in 30 provinces of China, 9 of them were not anesthesiologists, and 1 241 (99.28%) questionnaires were validated. In the valid questionnaires, 52.70% (654) of the anesthesiologists were from tertiary hospitals, and 74.78% (928) of the anesthesiologists were attending physicians or above, only 7.57% (94) of the anesthesiologists had sufficient confidence in AFBI. Twenty-five point two two percent (313) of the anesthesiologists preferred fiberoptic intubation as the first tool when dealing with the anticipated difficult airway. Forty-eight point one one percent (597) of the anesthesiologists had implemented AFBI. Among them, 80.74% (482) had experienced unsuccessful AFBI practices. Eight hundred and ninety-four anesthesiologists had received AFBI training, and the most common AFBI training strategy was theoretical lectures. In addition, the degree of satisfaction regarding the theoretical lectures quality, technical training, clinical practice relativity and non-technical skills training was 21.47% (192), 14.32% (128), 12.3% (110) and 17.90% (160), respectively. The degree of satisfaction with all the 4 training elements mentioned above was 7.27% (65).Conclusions:The awareness and practice of Chinese anesthesiologists in terms of clinical application of AFBI to treat difficult airways need to be strengthened at present, and the lack of high-quality AFBI training may be the key.
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OBJECTIVE：To investigate the effects of lidocaine aerosol inhalation on perioperative pulmonary function ， inflammation factor and related complications of patients with one-lung ventilation. METHODS ：A total of 120 patients who were admitted to the Affiliated Hospital of Panzhihua University from January 2018 to May 2020 and planned to undergo partial pneumonectomy under general anesthesia and one-lung ventilation were selected. According to random number table method ，they were divided into lidocaine aerosol inhalation group （group L ）and sterile water aerosol inhalation group （group N ），with 60 cases in each group. Two groups were given Midazolam injection 0.1 mg/kg+Propofol injectable emulsion 2.0 mg/kg+Sufentanil citrate injection 0.4 μg/kg to induce anesthesia. After the insertion of the double-lumen tracheal tube ，group L was given aerosol inhalation of Lidocaine hydrochloride injection 1.5 mg/kg diluted to 20 mL with sterile water ；group N was given aerosol inhalation of sterile water 20 mL at the flow rate of 2 L/min. Patients in both groups were continuously pumped with Propofol injectable emulsion 4-12 mg/（kg·h）+Remifentanil hydrochloride for injection 0.2-1 μg（/ kg·min）+Cisatracurium besilate for injection 0.05-0.1 mg/（kg·h）for anesthesia maintenance. Eight hours after operation ，group L inhaled of Lidocaine hydrochloride injection 1.5 mg/kg diluted to 20 mL with sterile water again ，and group N inhaled of sterile water 20 mL again. Arterial blood gas analysis indexes [arterial partial pressure of oxygen （PaO2），partial pressure of carbon dioxide （PaCO2），lactic acid （Lac），oxygenation index （P/F）]，serum inflammatory factors [interleukin 6 （IL-6），tumor necrosis factor α（TNF-α）and nuclear factor κB（NF-κB）] were observed in 2 groups before anesthesia（T1），60 min of one-lung ventilation （T2），and 12 h after extubation （T3）. Respiratory and circulatory parameters [extravascular lung water（EVLW），pulmonary vascular permeability index （PVPI），heart rate （HR），stroke volume （SV）] were also observed 5 min after anesthesia （t1），T2 and 15 min after surgery （t3）. Extubation time ，visual analogue scale （VAS） score of 12 h after extubation，time of getting out of bed ，the incidence of throat pain of 12 h after extubation and the occurrence of ADR were recorded in 2 groups. RESULTS ：There was no significant difference in arterial blood gas analysis indexes ，serum inflammatory factor levels ，respiratory and circulatory parameters between the two groups at T 1 or t 1（P＞0.05）. The levels of PaO 2，PaCO2， Lac，IL-6，TNF-α and NF-κB in 2 groups at T 2 and T 3 were significantly higher than at T 1，P/F at T 2 and T 3 was significantly lower than at T 1；in group L ，the levels of PaCO 2，Lac，IL-6，TNF-α，NF-κB were significantly lower than group N，and PaO 2 and P/F were significantly higher than group N （P＜0.05）. EVLW and PVPI of 2 groups at T 2and t 3，SV of group L ，HR of group N were significantly higher than corresponding group at T 1，while EVLW ，PVPI and HR of group L were significantly lower than group N，SV was significantly higher than group N at corresponding period （P＜0.05）. The extubation time ，VAS score of 12 h after extubation，time to get out of bed after surgery ，the incidence of throat pain of 12 h after extubation in group L were significantly shorter or lower than group N （P＜0.05）. No obvious and serious ADR occurred during recovery. CONCLUSIONS：Lidocaine aerosol inhalation can effectively improve ventilation and oxygenation function of patients undergoing one-lung ventilation ，inhibit the release of inflammatory factors ，and reduce the incidence of postoperative complications with good safety.
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Objective To investigate the current situation of labor analgesia in Shanghai, provide data supportion and decision-making basis for further popularization of labor analgesia.Methods Using the self-made questionnaire, Shanghai Medical Doctor Association of Anesthesiologist issued a notice on the purpose of the study and the way how to fill it up.The questionnaire was distributed and recycled through the website wjx.com.Results The 58 hospitals included in this survey accounted for 90.44％ of the total delivery in Shanghai in 2017, and the overall labor analgesia rate was37.22％.The number of deliveries in 13 maternal and child specialist hospitals accounted for 58.44％of 58 hospitals, and the labor analgesia rate was 56.75％.It accounted for 93.50％of the 58 hospitals analgesic deliveries.There are 44 (75.86％) hospitals carrying labor analgesia by intraspinal nerve block as the main method of labor analgesia.42 (95.45％) of these hospitals began to analgesia during the incubation period, 30 (68.18％) of these hospitals closed the analgesic pump during childbirth, and 40 (90.9％) hospitals had a maternal satisfaction of 85 or more, 36 (81.82％) of these hospitals charged labor analgesia in accordance with the anesthesia clause.However, among the 14 hospitals that did not practive labor analgesia, 13 (92.86％) were due to inadequate anesthesiologists and other relevant factors.Conclusion The overall labor analgesia rate in Shanghai was 37.22％.The service has been mainly provided in maternal and child specialist hospitals.The main factors restricting the labor analgesia are the shortage of anesthesiologists and the lack of specific charges.In order to promote the labor analgesia, policy support is an important aspect, and the labor analgesia process and innovative management mode should also be optimized.
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Objective To evaluate the efficacy of ultrasound-guided transversus abdominal plane (TAP) and posterior rectus sheath (PRS) block for postoperative analgesia in the patients undergoing radical resection for gastric cancer.Methods One hundred twenty patients of both sexes,aged 18-64 yr,with body mass index of 19-25 kg/m2,of American Society of Anesthesiologists physical status Ⅱ or Ⅲ,scheduled for elective radical resection for gastric cancer,were divided into 2 groups (n =60 each) using a random number table:control group (group C) and ultrasound-guided TAP and PRS block group (group T+R).Bilateral TAP (0.375％ ropivacaine 0.5 ml/kg was injected) and PRS block (0.375％ ropivacaine 0.3 ml/kg was injected) were performed before induction of general anesthesia in group T+R.Patient-controlled intravenous analgesia was provided to all the patients after surgery in the two groups,and the visual analog scale score at rest and during activity was maintained less than 4 within 48 h after surgery.The requirement for rescue analgesia within 48 h after surgery and occurrence of adverse reactions during the analgesia period were recorded.Results Compared with group C,the requirement for rescue analgesia within 48 h after surgery and incidence of nausea and vomiting were significantly decreased in group T+R (P＜0.05).Conclusion Ultrasound-guided TAP and PRS block provides better efficacy for postoperative analgesia with less adverse reactions in the patients undergoing radical resection for gastric cancer.
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Objective To investigate the effects of different doses of dexmedetomidine during com-bined intravenous-inhalational anesthesia on motor evoked potentials ( MEPs) monitoring and postoperative agitation in elderly patients undergoing cervical spine surgery. Methods Sixty patients of both sexes, aged 65-81 yr, weighing 51-78 kg, of American Society of Anesthesiologists physical statusⅠorⅡ, undergo-ing elective cervical spine surgery under general anesthesia, were divided into 3 groups ( n=20 each) using a random number table method: control group ( group C) , low-dose dexmedetomidine group ( group D1 ) and high-dose dexmedetomidine group ( group D2 ) . Anesthesia was induced by intravenous injection of mid-azolam 0. 04 mg∕kg, cisatracurium 0. 15 mg∕kg, propofol 2 mg∕kg and sufentanil 0. 3-0. 4 μg∕kg. MEPs was assessed with nerve electrophysiology monitor after induction of anesthesia. Anesthesia was maintained by inhalation of sevoflurane ( end-tidal concentration 1％) and target-controlled infusion of propofol ( target plasma concentration 2-3 μg∕ml). Narcotrend index was maintained at D2-E1. When T4∕T1>75％ (at T0 ) , dexmedetomidine was intravenously infused over 10 min in a loading dose of 0. 6μg∕kg, followed by an infusion of 0. 3μg·kg-1 ·h-1 until the end of surgery in group D1 . Dexmedetomidine was intravenously infused over 10 min in a loading dose of 1 μg∕kg, followed by an infusion of 0. 3 μg·kg-1 ·h-1 until the end of surgery in group D2 . The equal volume of normal saline was given intravenously in group C. At T0 , immediately after the end of administration of dexmedetomidine loading dose ( T1 ) and at 60 min of dexme-detomidine infusion ( T2 ) , the effective elicitation of MEPs and amplitude and latency of MEPs were recor-ded. The intraoperative cardiovascular events and occurrence of postoperative agitation in postanesthesia care unit were recorded. Results Compared with group C, no significant change was found in the latency, amplitude and effective elicitation rate of MEPs at each time point in group D1 ( P>0. 05) , the amplitude of MEPs was significanty decreased, the latency of MEPs was prolonged, and the elicitation rate of MEPs was decreased at T2 in group D2 , and the incidence of bradycardia during operation was significanty in-creased, and the incidence of postoperative agitation was decreased in D1 and D2 groups ( P<0. 05) . Com-pared with group D1 , the amplitude of MEPs was significantly decreased, the latency of MEPs was pro-longed, and the effective elicitation rate of MEPs was decreased at T2 ( P<0. 05), and no significant change was found in the incidence of intraoperative bradycardia and postoperative agitation in group D2 ( P>0. 05) . Conclusion Dexmedetomidine infused over 10 min in a loading dose of 0. 6 μg∕kg, followed by an intravenous infusion of 0. 3 μg·kg-1 ·h-1 until the end of surgery during combined intravenous-inhala-tional anesthesia exerts no effect on MEPs monitoring, and can decrease the incidence of postoperative agita-tion at the same time in elderly patients undergoing cervical spine surgery.
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Objective To evaluate the efficacy and safety of bilateral transversus abdominis plane block (TAPB)combined with bilateral rectus sheath block (RSB)in abdominal surgery. Methods Ninety ASA Ⅰ or Ⅱ patients,35 males,55 females,aged 19-79 years,with body mass index 18-30 kg/m2 ,scheduled for elective laparoscopic cholecystectomy were randomly divided into three groups(n=30):ultrasound-guided bilateral TAPB combined with bilateral RSB group (group TR),ultrasound-guided bilateral TAPB group (group T),patient-controlled intravenous analgesia (PCIA)group (group P).In group TR,ultrasound-guided bilateral TAPB were performed with 20 ml of 0.22% ropivacaine mesylate injection in each side and ultrasound-guided bilateral RSB were per-formed with 10 ml of 0.22% ropivacaine mesylate injection in each side before surgery.In group T, ultrasound-guided bilateral TAPB were performed with 20 ml of 0.22% ropivacaine mesylate injection in each side and ultrasound-guided bilateral RSB were performed with 10 ml of NS in each side before surgery.In group P,ultrasound-guided bilateral TAPB were performed with 20 ml of NS in each side and ultrasound-guided bilateral RSB were performed with 10 ml of NS in each side before surgery, and PCIA was applied in group P.BP,HR,SpO2 were observed when patients were sent into the op-erating room, 2 minutes before trocar puncture, and 2 minutes after trocar puncture, the consumption of propofol and remifentanil used during the surgery were recorded.The score of visual analogue scale (VAS)during rest and movement were recorded at 2,6,12,24 h after surgery.The patient analgesia satisfaction and the adverse reactions were recorded.Results Compared with group T and group P,group TR had less change of BP before and after trocar puncture(P <0.05).The VAS score was significantly lower in group TR after operation(P <0.05).There were no statistical significant differences of VAS score at 24 h after operation among the three groups.The patient anal-gesia satisfaction was significantly better in group TR than other two groups (P < 0.05 ). Conclusion Ultrasound-guided bilateral transversus abdominis plane block combined with bilateral rectus sheath block is of safety and much efficacy of postoperative analgesia in patients undergoing laparoscopic cholecystectomy.
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Objective To compare the postoperative cognitive function in elderly patients undergoing sevoflurane-based anesthesia versus propofol-based anesthesia.Methods Sixty-two patients of both sexes,aged 65-80 yr,weighing 48-90 kg,of ASA physical status Ⅰ or Ⅱ,were randomly allocated to either sevoflurane-based anesthesia group (group S,n=31) or propofol-based anesthesia group (group P,n =31).At 1 day before operation and 7 days after operation,cognitive function was assessed by MiniMental State Examination,Digit Span Test (forward test and backward test),Digit-Symbol Substitution Test,Trail Making Test A and Word Recognition Test,and the scores were recorded.Results There were no significant differences between the two groups in the scores of each test used for assessment of cognitive function.Compared to group P,Mini-Mental State Examination scores,forward test scores and backward test scores obtained from Digit Span Test,Digit-Symbol Substitution Test scores,and Word Recognition Test scores were significantly decreased at 7 days after operation,and no significant change was found in Trail Making Test A scores in group S.Conclusion Postoperative cognitive function is decreased under sevoflurane-based anesthesia when compared with that under propofol-based anesthesia in the elderly patients.
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Objective To evaluate the effects of sevoflurane on learning and memory of neonatal mice .Methods 122 neonatalmice (7 days postnatal) were included in this study .72 of them were exposed to sevoflurane (1 .0 or 0 .5MAC ,minimum alveolar concentration) or 40% O2 for 2 h(hours) .Morris water maze was performed 4 and 12 weeks after anesthesia .Latency and swimming speed during training ,time on island and times across island during the research were recorded .The rest 50 mice was used in artery blood analysis during sevoflurane (1 .0 or 0 .5 MAC ,0 ,1 ,2 h) .Results pH ,PaO2 ,PaCO2 ,SaO2 were stable during anesthesia .Latency in control group were significantly shorter than the two anesthesia groups 4 weeks after anes-thesia and 3 days after the training .During the last 2 training days ,the latency in 1 .0 MAC sevoflurane-exposed mice were sig-nificantly longer than that of the 0 .5 MAC group .12 weeks after anesthesia ,the latency was still significantly longer in 1 .0 MAC sevoflurane-exposed mice on the last training day .The time on island and/or times across island were significantly decreased in anesthesia groupsduring theresearch performed 4 weeks and 12 weeks after anesthesia .Conclusion Early exposure to sevoflurane leads to a concentration and time-depended persistent learning and memory deficits to neonatal mice .
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Dexmedetomidine( DEX) is a pure potent, highly se-lective and highly specific agonist ofα2-adrenergic receptors with sedative, analgesic and sympatholytic properties. The sedative effect mimics natural sleep of“arousable” and“cooperative” se-dation without respiratory depression. Due to the above properties and advantages, DEX has received adequate attention in clinical practice and its spectrum of application is also expanding. In re-cent years, it is proved that DEX is neuroprotective not only in animal researches but also in clinical studies. The neuroprotec-tion of DEX and its related mechanism will be briefly reviewed in this paper.
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Objective To evaluate the efficacy and safety of domestic palonosetron hydrochlo-ride injection on its prevention of postoperative nausea and vomiting.Methods A multi-centered,ran-domized,double-blinded and placebo-controlled clinical trial was carried out.A total of 281 patients were enrolled,with 141 of patients in study group and 140 of patients in control group respectively. 0.075 mg of intravenous palonosetron hydrochloride injection was delivered in the study group before anesthesia induction.The drug was substituted by 1.5 ml of NS in the control group.All anesthesia inductions were conducted by the intravenous injection of propofol,fentanyl and rocuronium,and were maintained with sevoflurane and fentanyl.Complete remission rate and treatment failure cut-off time of vomiting were evaluated at 0-6 h,6-72 h,0-72 h postoperatively.Results In the study group CR% 0-6 h,6-72 h and 0-72 h were 107 (75.89%),104 (73.76%)and 92 (65.25%),the control group was 81 (57.86%),70 (50%)and 62 (42.86%),CR% of the study group was significantly higher than that of the control group (P <0.01).Insignificant statistical difference but significant clin-ical difference exists in their treatment failure cut-off time,386.5 min and 300.0 min,respectively be-tween the groups.Conclusion Domestic palonosetron hydrochloride injection is safe and effective in the prevention of postoperative nausea and vomiting.
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Objective To evaluate the effects of different concentrations of sevoflurane anesthesia on longterm learning and memory abilities in neonatal rats.Methods Twenty-seven neonatal Sprague-Dawley rats of both sexes,aged 7 days,weighing 12-20 g,were randomly assigned into 3 groups (n =9 each):control group (C group),2％ sevoflurane group (S1 group) and 3％ sevoflurane group (S2 group).Groups C,S1 and S2 inhaled air,2 ％ sevoflurane and 3 ％ sevofluran for 4 h,respectively.The neonatal rats were reared to 35 days old and underwent open field test,to 36 days old and underwent Morris water maze test,and to 42 days old and underwent continuous multiple-trail inhibition avoidance training.Results Open field test:There was no significant difference in the movement time,movement speed and the time the animals spent in the central square among the 3 groups (P ＞ 0.05).Morris water maze test:Compared with C group,the looking for platform latency on 2nd-5th days in S2 group and on 2nd-3rd days in S1 group was significantly prolonged,and the percentage of time of staying at the platform quadrant was decreased in S1 and S2 groups (P ＜ 0.05 or 0.01).The looking for platform latency on 3rd4th days in S2 group was significantly longer than that in group S1 (P ＜ 0.05).Continuous multiple-trail inhibition avoidance training:The latency detected at 24 h after training was significantly shorter in S1 and S2 groups than in group C (P ＜ 0.05),and in group S2 than in S1 group (P ＜ 0.05).Conclusion Sevoflurane anesthesia decreases the long-term learning and memory function in neonatal rats in a concentration-dependent manner.
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Objective To investigate the effects of bone mesenchymal stem cells (BMSCs)transplantation on the neurological function recovery of injured spinal cord and the underlying mechanism.Methods Rats were subjected to contusive spinal cord injury by using NYU spinal cord contusive impactor system ( NYC lmpactor).Seven days after spinal cord injury,the transplantation of BMSCs ( BMSCs group) or injection of PBS ( PBS group) was performed around the epicenter of injured spinal cord in rats.Basso-Beattie-Bresnahan (BBB) score was used to evaluate the function of spinal cord.The cavity volume of the injured spinal cord was measured and the axons in the injury center of spinal cord were examined under transmission electron microscopy.The BMSCs of the green fluorescent protein (GFP)transgenic rats were used to trace the transplanted cells and the survivor of BMSCs in the injured spinal cord and their differentiation into neural cells were observed.A mini-channel implantation model was employed to further investigate the role of BMSCs transplantation on the axonal regeneration.Results The BMSCs group showed a higher BBB score and a smaller lesion volume as compared with the PBS group.Transmission electron microscopy examination displayed that the number of axons in the BMSCs group was far more than that in the PBS group.A great number of BMSCs-GFP were founded around the center of the injured spinal cord at 4 weeks after BMSCs transplantation.lmmunohistochemistry showed that the implanted BMSCs-GFP did not express the surface marker of neurons,astrocytes and oligodendrocytes.In the mini-channel implantation model,NF-positive nerve fibers grew into the BMSCs-seeded channel,while there were no nerve fibers in the channel without seeding of BMSCs.Conclusions The BMSCs transplantation for the injured spinal cord promotes its functional recovery,and the related mechanism is in correlation with BMSCs transplantation inducing axonal regeneration.
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Objective To compare the phaimacodynamics and circulatory function of domestic and imported rocuronium. Methods This is a five center study of rocuronium. Two hundred and ten ASA Ⅰ or Ⅱ patients aged 18-65 yr undergoing elective surgery under general anesthesia were randomly divided into 2 groups (n = 105 each): domestic rocuronium group (group Ⅰ ) and imported rocuronium group (group Ⅱ ) . Anesthesia was induced and maintained with TCI of propofol (target plasma concentration = 3 mg/L) and remifentanil (target effect-site concentration = 2-4 μg/L) . Tracheal intubation was facilitated with intravenous rocuronium 0.6 mg/kg. The N-M function was assessed by accelerography (TOF-Watch(R) SX, Organon, Netherlands) using TOF stimulation of ulnar nerve. Onset time, clinical duration, 75% recovery time,recovery indexes, the extent of maximal NM blockade and intubation conditions (ease of laryngoscopy, position of vocal cords and airway reaction) were monitored and recorded. BP and HR were also recorded. Results There were no significant differences in the onset time, clinical duration, recovery indexes, the extent of maximal N-M blockade, the intubation conditions, BP, HR and adverse reactions between groups Ⅰ and Ⅱ ( P ＞ 0.05) . The 75% recovery time was significantly longer in group Ⅱ than in group Ⅰ (P ＜ 0.05＝. Conclusion The pharmacodynamics of domestic and imported rocuronium is comparable. The two drugs have no adverse effect on the circulatory function.
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Objective To construct and identify adenovirag (Ad-RUNEP) carrying human B-endorphin(B-EP) genes which can be regulated by mifepfistone (RU486)-inducible system and to evaluate the effects of different concentrations of RU486 on the transgene expression in adenovirus in vitro.Methods The shuttle plagmid pDC312一RUNEP carrying B-EP genes which can be regulated by RU486-inducible system was constructed and was combined with adenovims to form a recombinant Ad-RUNEP using AdMAXTM system.The recombinant Ad.RUNEP was then amplified and purified.The titers of the adenovirus were determined and the adenovirus vector was checked.After being infected by Ad-RUNEP for 24 h,A431 cell line was incubated in liquid culture media containing RU4860,10-10,10-9,10-8,10-7,and 10-6 mol/L respectively(group R0-5) for 48h,and Was then transferred to liquid culture media containing no RU486.The liquid culture media were obtained on 1st.2nd and 4th day of incubation and centrifuged.The supematant Was collected for determination of B-EP concentration by ELISA.Results The analysis of enzyme-incision demonstrated that RU486 regulating system and B-EP were cloned directly into pDC312-RUNEP.The titer of Ad-RUNEP was 2.25×1010 pfuml.The expression of B-EP was significantly higher in group R1-s than in group R0 and was significantly lower in group R1-3 than in group R4 (P<O.05).The expression of B-EP wag significantly higher on 2nd than on 1st and 4th day.Conclusion The adenovims carrying B-EP genes which can be regulated by RU486 (Ad-RUNEP) Wag successfully constructed.
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Objective To investigate the effects of propefol on β-amyloid protein(β-AP)-induced injury to cultured rat cortical neurons.Methods Eighteen days pregnant SD rats were anesthetized with ether.The fetal rats were obtained under sterile condition and decapitated. Cortices were then dissected under dissecting microscope.Cortical neurons were isolated according to the method described by Velly LJ et al and cultured for 7 days.There were 5×104 neurons in each well (200 μl).The experiment included 2 parts.In part T 15 wells of neurons were randomly divided into 5 groups(n=3 each ) : group I control(C);group II β-AP 25 μmol/L; group III and IV 2 propofol pretreatment groups (PP1,PP2) and greup V propofol treatment (PT).In group PPt propofol 50 μmol/L was added to the culture medium 24 h before the addition of β-AP 25 μmol/L and the neurons were incubated for another 24 h.In group PP2 propofol 50 μmol/L and μ-AP 25 μmol/L were added to the culture medium simultaneously and the neurons were then incubated for 24 h.In group PT propefol 50 μmol/L was added to the culture medium at 6 h after the addition of β-AP 25 μmol/L and the neurons were incubated for another 18 h.In part Ⅱ 18 wells of neurons were randomly divided into 6 groups(n=3 each):group I control (C) ; group IIβ-AP 25 μmol/L; group III intralipid; group IV,V,and VI 3 prepofol treatment groups (P1,P10,P50).In intralipid group equal volume of 10% intralipid was added to the culture medium at 6 h after β-AP 25 μmol/L and the neurons were then incubated for another 18 h.In group IV- VI propofol 1,10 and 50 μmol/L were added at 6 h alter β-AP 25 μmol/L respectively and the neurons were incubated for another 18 h.The amount of lactic dehydrogenase (LDH) released was measured.Neuronal viability was assessed by MTT assay.The neuronal apoptosis was detected using Hoechst33342 staining and TUNEL technique,and the.apoptosis rate was calculated.Results In part Ⅰ there was no significant difference in the amount of LDH released between group Ⅱ(β-AP) and the 2 propofol pretreatment groups(Ⅲ,Ⅳ).The amount of LDH released was significantly lower in group Ⅴ (propofol treatment) than in group β-AP(Ⅱ).In part Ⅱ the amount of LDH released was significantly lower,neuronal viability higher and the apoptosis rate was lower in group P50 than in group Ⅱ(β-AP).Conclusion Propofol 50 μmol/L given after β-AP can attenuate β-AP induced injury to cultured rat cortical neurons while prophylactic administration of propofol can't.
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Objective To evaluate the desflurane-induced sympathetic activation with finger tip perfusion index (FTPl). Methods Forty-eight ASA ⅠorⅡ patients aged 25-60 yr undergoing elective surgery under general anesthesia were randomly divided into 3 groups (n=16 each): groupⅠsevoflurane; group Ⅱ desflurane and groupⅢ desthrane + propofol. Anesthesia was induced with midazolam 0.03 mg/kg, propofol 2 mg/kg and fentanyl 2 μg/kg. Tracheal intubatian was facilitated with vecuronium 0.1 mg/kg. The patients were mechanically ventilated (VT 8-10 ml/kg, RR 12 bpm). PETCO2 was maintained at 35-40 mm Hg. In group ⅠandⅡanesthesia was maintained with sevoflurane and desflurane respectively. The end-tidal concentration of sevoflurane and desflurane were rapidly increased to 0.5 MAC, 1.0 MAC and 1.5 MAC and maintained at each level for 5 rain. In group Ⅲanesthesia was maintained with TCI of propofol and destlurane. The target plasma prepofol concentration was set at 1 μg/ml and the end-tidal concentration was rapidly increased to 0.5 MAC and 1.0 MAC and maintained at each level for 5 mitt. MAP, HR, FTPI and BIS were continuously monitored and recorded at 5 rain after midazolam (T0), 3 rain after induction of anesthesia (T1), immediately after tracheal intubation (T2), as soon as the end-tidal concentration of sevoflurane and desflurane reached 0.5 MAC(T3), 1.0 MAC(T5) and 1.5 MAC(T7) and after being maintained at 0.5 MAC (T4), 1.0 MAC (T6) and 1.5 MAC (T8) for5 rain. The plasma renin activity and the levels of angintonin Ⅱwere determined at T0, T1, T2, T5 and T7 by using radioimmuno-ssay. Results FTPI was significantly lower at T5 than at T4 in group Ⅱ HR and MAP were significantly lower at T4-6 and T8 and FTPI were significantly lower at T3～6 and T0 than at T7 in group Ⅱ. HR and MAP were significantlyhigher while FTPI was lower at T7 in groupⅡthan in group Ⅰ The changes in MAP and FTPI between T4 and T5 were significantly less in group Ⅲthan in group Ⅱ. The time when the highest value of FTPI was maintain was significantly shorter than the time when the highest values of HR and MAP were maintained at T5 and T7 in group ⅡΔFTPI was negatively correlated with ΔHR and ΔMAP (r=-0.593, P<0.05;r=-0.591, P<0.05). Conclusion FTPI can reflect the desflurane-induced sympathetic activation promptly and sensitively.
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As the neuron-specific actin binding protein,Drebrin ( developmentally regulated brain protein) can affect spiny and synaptic morphology and function by changing the property of cytoskeleton,and modulate synaptic plasticity. Neural excitability regulates expression and activitiy of Drebrin through a variety of signaling molecules,making Drebrin' s function correlated with that of neurons. Under pathological conditions,the abnormal Drebrin affects synaptic plasticity,which leads to different degrees of cognitive dysfunction,and it is closely relates to the progress of cognitive dysfunction. Extensive studies of physiological and pathological functions of Drebrin in overall and molecular ways will not only contribute to a thorough understanding of cognitive dysfunction,but also develop the new target of therapeutics for cognitive dysfunction.
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Pathologic pain is a common suffering and does great harm to people health. Therefore it is important to search some suitable targets for pain management. Recently it has been shown that activated inflammatory cells and glia are strongly implicated in the pathologic pain. Cyclic 3',5'-adenosine monophosphate,a universal intracellular second messenger,has been proven to inhibit the activity of inflammatory cells and glia by enhancing its activity,further to control pathologic pain. This review presents the current understanding of the underlying mechanisms for the inhibitive effect of cAMP signal pathway in inflammatory cells and glia,and the effect of phosphodiesterase inhibitors used for relieving pathologic pain.
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Aim To investigate the effects of propofol on focal cerebral ischemia and the changes of protein kinase C isoform ?(PKC?) expression in rats brain. Methods Male SD rats were randomly allocated into five groups: Ⅰ: sham group, Ⅱ: injury group, Ⅲ: propofol (25 mg?kg-1) plus injury group, Ⅳ: propofol (50 mg?kg-1) plus injury group, Ⅴ: intralipid plus injury group. The focal cerebral ischemia was induced by 3 h of middle cerebral artery occlusion (MCAO) and 24 h of reperfusion. 30 min before reperfusion, propofol and intralipid were infused intraperitoneal of the rats in groups Ⅲ, Ⅳ, Ⅴ, respectively. After 24 h of reperfusion, rats were weighted and the neurological deficit was assessed by 5-point scale. Brain pathologic changes were observed by HE staining, the method of terminal deoxynucleotidyl transferase mediated dUTP-biotin nick end labeling (TUNEL) was carried out for the assessment of neural apoptosis, and immunocytochemistry was used to investigate the changes of PKC?.Results After 3 h of MCAO and 24 h of reperfusion, the weight of rats in group Ⅱ, Ⅲ, Ⅳ, Ⅴ decreased and their neurological deficits scores increased. Compared to the rats of sham group, the numbers of apoptosis neurons in striatum were marked-ly increased, and the expression of PKC? were significantly decreased in rats of injury group (P
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<p><b>OBJECTIVE</b>To assess the possibility of using arterial pressure waveform or pulse oximetry plethysmographic waveform variation to estimate the pulmonary arterial wedge pressure (PAWP).</p><p><b>METHODS</b>Fourteen American Society of Anesthesiologists grade I - II patients aged 33 - 69 years and weighing 62.0 +/- 9.5 kg scheduled for elective abdominal tumor surgery were studied. Their hemoglobin exceeded 120 g/L and hematocrit exceeded 35 percent. Pre-operative acute hypervolemic hemodilution was applied immediately after general anesthestic induction and tracheal intubation. PAWP, systolic pressure variation (SPV), delta down (dDown), SPV(plet), dDown(plet) and other hemodynamic parameters were measured and recorded when total fluid volume (crystalloid and colloid) infused reached 10 ml/kg and 20 ml/kg and again at the end of the operation. Central venous pressure was maintained at 10 - 12 mm Hg during operation. Systolic blood pressure at the end of Valsalva maneuver (airway pressure was kept at 22 mm Hg) and the systolic pressure before the Valsalva manoeuvre during apnea were used to calculate arterial pressure ratio (APR).</p><p><b>RESULTS</b>APR, SPV, dDown, SPV(plet) and dDown(plet) all correlated well with PAWP (r = 0.717, -0.695, -0.680, -0.522 and -0.624 respectively, P < 0.01). There was a closer linear correlation between APR and PAWP than between the other parameters. The regression equation was PAWP (mm Hg) = 0.207 x APR (%) - 0.382.</p><p><b>CONCLUSION</b>During positive pressure mechanical ventilation, APR, SPV, dDown, SPV(plet) and dDown(plet) can be used to estimate PAWP effectively.</p>